What’s New in Bone Cancer Research?

Research on bone cancer is now being done at many medical centers, university hospitals, and other institutions around the world. There are many clinical trials focusing on bone cancer.

Because primary bone cancer is rare in adults, it's been hard to study well. Most experts agree that treatment in a clinical trial should be considered, especially for people with advanced bone cancers (those that come back after treatment, don't respond to treatment, and/or spread to other parts of the body). This way people can get the best treatment available now and may also get the treatments that are thought to be even better.

Treatment

Chemotherapy

Some studies are testing new chemo drugs. Researchers are also looking for new, and maybe better, ways to use the drugs we have. For instance, doctors are studying whether adding a bisphosphonate called zoledronic acid (Zometa) to the
bone cement used to fill in the space left after removing a giant cell tumor might decrease the chance that the tumor will come back in that place.

Another area of interest is long-term
chemotherapy side effects. Bone cancers are some of the more common cancers in young people, and doctors are trying to learn more about how the chemo drugs used might affect the way the brain develops and works as survivors grow older.

Targeted therapy

A huge area of primary bone cancer research is learning more about the genetic changes in these cancer cells. Researchers are using existing drugs and developing
new targeted drugs that focus on these gene changes. It's hoped that these drugs can change the cancer's ability to grow and spread, providing a new and better way to treat these tumors.

For instance, researchers have found that some giant cell tumors that have low levels of certain genes (called
microRNA genes) are able to grow and spread faster. MicroRNA changes have also been found in
chondrosarcomas. Tests that find these microRNA changes may be helpful in diagnosing these tumors.
Finding drugs that target these genes might also prove to be a possible treatment.

One targeted therapy drug, nivolumab (Opdivo), is already used to treat other kinds of cancer. Doctors are trying to find out the best dose to
use. They are looking at whether combining it with other treatments might slow tumor growth and help people with advanced sarcomas live longer.

The targeted therapy drug dasatinib (Sprycel) is also used to treat other cancers. Early studies have suggested it may help treat chondrosarcomas, both alone and combined with chemo. Chondrosarcomas
seldom respond to chemo or radiation, so targeted therapy drugs may lead to new treatments for these hard-to-treat cancers.

Denosumab (Prolia or Xgeva) is another targeted therapy being tested to see if it can help control giant cell tumor of the bone and/or keep it from
coming back after treatment. It's also been shown to help keep giant cell tumors from coming back after surgery.

Overall, results of targeted therapy research are not yet clear. More research is needed in this area, and many clinical trials are testing these treatments.

Radiation

The most common type of radiation used to treat cancer uses beams of x-rays. Doctors are looking for better types of radiation. Proton beam radiation uses particles made up of protons. (Protons are small positively charged particles that are part of atoms.) Proton radiation is already used to treat bone tumors near very sensitive organs, like the brain or the spine.
It's being tested on tumors in other parts of the body, too. And as advances make this treatment even more precise and more widely available, it may be found to work better in treating bone tumors.

Another much less common form of particle radiation that has been used to treat chordomas and chondrosarcomas is carbon ion radiation.
This may be helpful in treating tumors that do not respond to available treatments, but a lot more research is needed. This treatment is only available in 10 centers worldwide, and there are no carbon ion radiation facilities in North America as of 2017.

Genetics

In addition to clinical trials, researchers are making progress in learning about the causes of bone tumors. For example, changes to the
T gene have been found in a few families where more than one member has a chordoma. This might help doctors find specific gene changes that might put a person at higher risk for this type of bone cancer.

Other gene changes found in giant cell tumors may help doctors find better ways to
both diagnose and treat these tumors.

Scientists hope that learning more about the DNA changes that cause bone cancers will also lead to better treatments that might be aimed at these gene defects.